Tailored therapy for aggressive non-Hodgkin's lymphoma: Results of a phase II study with a long-term follow-up

Giovannella Palmieri, Alessandro Morabito, Antonio Rea, Edoardo Biondi, Rossella Lauria, Elide Matano, Clorindo Pagliarulo, Vincenzo Montesarchio, Pierosandro Tagliaferri, Angelo Raffaele Bianco

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Abstract

Aim of the study was to improve cure rate and survival of aggressive non-Hodgkin's lymphoma (NHL) with a tailored program of therapy based on histologic type, prognostic characteristics of patients and response to therapy, and with the use of differentiating or cytostatic agents such as Ara-C at low doses and αIFN. Fifty-four consecutive patients with aggressive NHL were treated in the induction phase with 4 sequential courses of a third generation regimen (modified CODBLAM IV), followed in responsive patients by I cycle of doxorubicin and cyclophosphamide and I cycle of high dose methotrexate with folinic acid rescue (AC-MTX). Patients who achieved partial response (PR) were treated with the combination of CCNU + vinblastine if affected by high grade NHL, or with low dose Ara-C plus αIFN if affected by intermediate grade NHL. Patients who obtained complete response (CR) with basal adverse prognostic factors were treated with αIFN as maintenance therapy for two years. Radiotherapy and surgery were effected in selected cases. Thirty-four patients (62.9%) achieved CR and 12 patients (22.2%) showed PR after induction therapy. Among the 12 patients who achieved PR, 6 prolonged CRs were obtained in 7 patients treated with Ara-C at low doses plus αIFN and 4 CRs were obtained in 5 patients treated with CCNU + vinblastine. After completion of treatment, 44 patients (81.5%) obtained CR, 2 patients (3.7%) showed PR and 8 patients (14.8%) presented progression of disease (PD). Fifteen patients received αIFN as maintenance therapy. The overall survival and failure-free survival rates are 53.7% and 50% respectively, with a median follow-up of 82 months: 27 patients remain alive, disease-free without relapses, and can be considered cured. This tailored program of therapy resulted effective and moderately toxic and may improve the outcome in aggressive NHL.

Original languageEnglish
Pages (from-to)121-127
Number of pages7
JournalInternational Journal of Oncology
Volume13
Issue number1
Publication statusPublished - Jul 1998

Keywords

  • Cytostatic agents
  • Differentiating agents
  • Non-Hodgkin's lymphoma
  • Tailored therapy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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    Palmieri, G., Morabito, A., Rea, A., Biondi, E., Lauria, R., Matano, E., Pagliarulo, C., Montesarchio, V., Tagliaferri, P., & Bianco, A. R. (1998). Tailored therapy for aggressive non-Hodgkin's lymphoma: Results of a phase II study with a long-term follow-up. International Journal of Oncology, 13(1), 121-127.